A “buffalo hump” refers to a noticeable fat deposit that forms at the base of the neck, between the shoulder blades. While often a cosmetic concern, this accumulation of fat, medically known as a dorsocervical fat pad, can sometimes indicate an underlying health issue. Understanding the potential causes is key to appropriate management.
What is a Buffalo Hump?
A buffalo hump is an accumulation of fatty tissue on the back of the neck, between the shoulder blades. This fat pad creates a visible hump-like appearance. It is considered a physical manifestation or symptom, rather than a disease in itself. This fat pad is distinct from a “dowager’s hump,” which refers to an excessive curvature of the upper spine (kyphosis) caused by poor posture or osteoporosis.
Medical Conditions as Causes
Several medical conditions can lead to a buffalo hump by affecting fat metabolism and distribution. Cushing’s Syndrome is a prominent cause, resulting from prolonged exposure to high levels of cortisol. Excess cortisol promotes fat redistribution, leading to its accumulation in areas like the neck, face (“moon face”), and abdomen (central obesity). This occurs because cortisol can stimulate lipolysis (fat breakdown) in some areas while promoting fat storage in others.
Less common conditions can also contribute to a buffalo hump. Lipodystrophy, an abnormal fat distribution, can cause fat loss in some body areas and fat buildup in others, including the neck and shoulders. Certain rare genetic disorders, such as Madelung’s disease (multiple symmetrical lipomatosis), are characterized by unusual fat deposits in the neck, shoulders, and upper arms. Tumors of the adrenal gland or pituitary gland can also lead to increased cortisol production, causing a buffalo hump.
Medications and Lifestyle Factors
Medications can induce a buffalo hump as a side effect, particularly those that mimic or influence cortisol levels. Long-term use of corticosteroids like prednisone, cortisone, and hydrocortisone can lead to fat redistribution similar to that seen in Cushing’s Syndrome, as these medications act like cortisol in the body. Additionally, some antiretroviral drugs, particularly older types used in HIV treatment, have been linked to lipodystrophy, causing excessive fatty tissue to develop in the upper back.
Beyond medication, certain lifestyle factors can contribute to or mimic the appearance of a buffalo hump. Significant obesity can lead to excess fat deposits throughout the body, including the neck region. Chronic poor posture, such as prolonged leaning forward or looking downward, can weaken neck and upper back muscles, leading to an exaggerated forward curvature of the spine (kyphosis), which can create a hump-like appearance or exacerbate an existing fat pad.
Diagnosis and Management
Diagnosing a buffalo hump typically begins with a physical examination by a healthcare provider and a detailed patient history, including current medications. To identify the underlying cause, various diagnostic tests may be ordered. Blood tests check hormone levels, particularly cortisol, if an endocrine disorder like Cushing’s Syndrome is suspected. Imaging studies such as X-rays or MRI scans of the neck can help characterize the fat pad, distinguish it from spinal curvature, and rule out other masses.
Management of a buffalo hump primarily focuses on addressing the root cause. If Cushing’s Syndrome is diagnosed, treatment may involve surgical removal of tumors, medication adjustments, or other therapies. For humps caused by medications, a doctor may adjust the dosage or switch to alternative drugs, though patients should never stop prescribed medications without medical guidance. When obesity contributes, lifestyle changes such as diet and exercise are recommended for overall weight loss. While cosmetic interventions like liposuction can remove the fat deposit, they are secondary options, as the hump may return if the root problem persists.
When to Consult a Doctor
Consult a doctor if a buffalo hump is new, growing rapidly, or accompanied by other concerning symptoms. These symptoms might include unexplained weight gain, muscle weakness, easy bruising, changes in facial appearance, or high blood pressure. A medical professional can accurately diagnose the cause through a thorough examination and testing. Early diagnosis and treatment of the underlying condition can help prevent potential complications and ensure appropriate health management.